Guan Chun-Shuang, Wang Xue-Mei, Lv Zhi-Bin, Yan Shuo, Sun Lei, Xie Ru-Ming
Department of Radiology.
Department of Ultrasonography.
Medicine (Baltimore). 2018 Oct;97(41):e12530. doi: 10.1097/MD.0000000000012530.
Kaposi's sarcoma (KS) is the most common malignant tumor in HIV-infected people and occurs mainly in the skin, mucous membranes, and lymph nodes. Approximately 33% of the initial skin manifestations of AIDS and approximately 35% to 79% of KS occur during disease progression. Otherwise, AIDS-related facial KS that was simultaneously examined by magnetic resonance imaging (MRI) is rare.
This case was a 30-year-old male homosexual, with left facial nodule for 14 months, and HIV infection was diagnosed 1 month previously. The patient was admitted to hospital because the nodule gradually expanded from 0.2 to 10.0 cm in diameter. Ultrasound examination showed edema of the subcutaneous tissue of the left facial mass, and the boundary was not clear between lesion and normal tissues. Magnetic resonance imaging (MRI) indicated that the left facial mass showed low signal intensity on T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI), and a small amount of high signal intensity was seen in it. Diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI) showed low signal intensity. After enhanced scan, the tumor showed uneven enhancement.
The pathological biopsy indicated KS.
The patient began chemotherapy with the intravenous drip infusion of Doxorubicin Hydrochloride Liposome.
The facial KS decreased and the facial swelling was relieved.
MRI could not only provide the diagnostic basis of KS for the therapy, but also could accurately determine the scope of the disease.
卡波西肉瘤(KS)是人类免疫缺陷病毒(HIV)感染者中最常见的恶性肿瘤,主要发生于皮肤、黏膜和淋巴结。约33%的艾滋病初始皮肤表现以及约35%至79%的卡波西肉瘤发生于疾病进展期。此外,同时接受磁共振成像(MRI)检查的艾滋病相关面部卡波西肉瘤较为罕见。
该病例为一名30岁男性同性恋者,左侧面部结节14个月,1个月前确诊HIV感染。患者因结节直径从0.2 cm逐渐增大至10.0 cm而入院。超声检查显示左侧面部肿物皮下组织水肿,病变与正常组织边界不清。磁共振成像(MRI)显示左侧面部肿物在T1加权成像(T1WI)和T2加权成像(T2WI)上呈低信号强度,内见少量高信号强度。扩散加权成像(DWI)和磁敏感加权成像(SWI)呈低信号强度。增强扫描后,肿瘤呈不均匀强化。
病理活检提示为卡波西肉瘤。
患者开始采用静脉滴注盐酸阿霉素脂质体进行化疗。
面部卡波西肉瘤缩小,面部肿胀缓解。
MRI不仅可为卡波西肉瘤的治疗提供诊断依据,还能准确确定疾病范围。